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Patricia M. Cerqueira, Felipe T. da Silva, Pedro C. Carricondo, Edilberto Olivalves, Carlos E. Hirata, Joyce H. Yamamoto; Observation On Surgical Results Of Complicated Cataract In Patients With Uveitis. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6645.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the outcomes of phacoemulsification with intraocular lens (IOL) implantation in eyes with uveitis.
Consecutive patients with uveitis and visually significant cataract were retrospectively studied for outcomes after phacoemulsification and polymethylmethacrilate (PMMA) IOL. Inflammation was quiescent for at least three months before the planned cataract surgery. Eight patients were under systemic immunosuppressant. Preoperative prophylactic oral prednisone (0.5mg/kg/day ) was given for at least three days before the surgery in non-infectious uveitis.
The study comprised 36 eyes of 31 patients (17 women, 14 men) with a mean age of 48.5+13.3 years (SD) (range 20 to 79 years) and mean disease duration of 52+88.9 months (range 15 to 384 months). Mean postoperative follow-up was 17.8+10.2 months (range 6-48 months). Infectious and non-infectious uveitis were observed in 8 (22.2%) and in 23 (63.9%) eyes, respectively, mainly comprising toxoplasmosis (n=5), presumed tuberculosis (n=3), Vogt-Koyanagi-Harada disease (n=7), sympathetic ophthalmia (n=2) and Fuchs heterochromic cyclitis (n=3). PMMA IOL was implanted in-the-bag in all eyes. All patients received postoperative topical dexametasone. At the final follow-up examination, 30 eyes (83.3%) had improved visual acuity by 2 or more lines; 20 eyes (55%) achieved a postoperative visual acuity ≥ 0.5. The mean corrected distance visual acuity was 0.06+0.18 (range 0.01-0.4) preoperatively and 0.61+0.41 (range 0.001-1) postoperatively; the improvement was statistically significant (p<0.001, Wilcoxon related test). Posterior capsule opacification was observed in 8 eyes (22%). Persistent postoperative inflammation (> 6 months) were observed in four eyes (11.1%) and recurrence occurred in three eyes (8.3%). IOL was explanted in one eye 2 months after surgery due to intense inflammation and glaucoma. Intraocular hypertension was observed in four eyes (11.1%).
Phacoemulsification with IOL implantation improved vision in most patients with coexisting cataract and uveitis. Good preoperative and postoperative control of inflammation are important factors for the good visual outcome. The final visual outcome depends on the posterior segment findings.
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